4.2.3 HIV/AIDS/HEP C

YARD Workshop 3 HIV AIDS HEP C

Eva’s Satellite- Harm Reduction Program

YARD

PURPOSE:

  • Provide accurate and current information to increase awareness and educate
  • Increase coping strategies to support healthier choices
  • Increase knowledge of HIV/AIDS and HEP C
  • Promote acceptance, increase positive social participation
  • Engage youth in pro-social peer discussions/interaction
  • Engage youth in actively participating/facilitating groups to increase sense of accomplishment/positive feelings

OBJECTIVES:

  • Learn effective strategies for safer interactions
  • Help prevent the spread of new infections of HIV/AIDS and hepatitis C
  • Teach youth safe practices and universal precautions
  • Learn about community resources

APPROACH:

  • Youth ages 16-24, living in the shelter or in the community (supportive or independent living)
  • Short attention span, need high energy, increased participation and engagement strategies/activities
  • Establish rules for group safety (with participants input and the non-negotiable rules we  must have whenever groups are delivered)
  • Time frame for groups will be 45-60 minutes; breaks scheduled at a third way or half way through   the group; or when needed

CONTENT OUTLINE:

Create an outline that break topic into sections (manageable topics for 45 minute sessions), including activities, handouts, resources needed and any community presenters; ensure sequence creates flow, builds momentum, increases engagement and achieves best result

  • Introduction
    • establish/review rules
    • introduce topic
    • what to expect
  • Section A
    • Activity 1 – Myths vs. Reality
  • Discussion Topics
    • What is the Difference Between HIV and AIDS
    • How Is It Transmitted?
    • Signs of Infection
  • Break (5-10 minutes)
  • Section B
    • Activity 2- Watch It Spread
  • Discussion Topics
    • What is Hep C?
    • How is Hep C transmitted
    • How to reduce your chances of contracting HIV or HEP C
    • Pictures of a healthy liver and an unhealthy liver
  • Wrap up / Handouts / Survey

Activity 1 True or False – Myths vs. Reality

What you do think?

  1. Put up the ‘STRONGLY AGREE’ and ‘STRONGLY DISAGREE’ sheets on the wall at opposite ends of the room.
  2. Explain to the group as a whole that you will read out a series of statements, one at a time. Each person is to think about whether they agree or disagree with it, and move to the appropriate side of the room. It is all right to stay in the middle if they are uncertain.
  3. Hand out the True or False Question sheet and read the first statement. Once everyone has moved to their chosen place, ask members to choose one person near them and discuss why they are standing where they are.
  4. Now ask people to choose one person standing as far away from them as possible, and to discuss the statement with them, explaining why each has chosen to be where they are.
  5. Repeat the procedure with as many statements as time allows.
  6. Re-assemble as a group and, going round the group, ask each individual to identify one piece of information they are confused or unclear about. Ask members of the group to clarify the issues involved and intervene yourself where necessary.

Likely outcomes

At the end of the exercise, it will be clear what areas of uncertainty remain. Individuals will have had a chance to think about ways of HIV transmission, and to discuss these with other group members. People can sometimes become quarrelsome during this exercise so you may need to intervene to settle disputes.

True/False Question Sheet

  1. You can become infected with HIV by sleeping around.
  2. Injecting drugs will give you HIV.
  3. You can get HIV from toilet seats.
  4. If you are fit and healthy you won’t become infected with HIV.
  5. Married people don’t become infected with HIV.
  6. If you stick with one partner you won’t become infected with HIV.
  7. Women are safe from HIV as long as they use a contraceptive.
  8. You can become infected with HIV from sharing toothbrushes.
  9. If you have sex with people who look healthy, you won’t become infected with HIV.
  10. If you only have sex with people you know, you won’t become infected with HIV.
  11. Anal sex between two men is more risky than anal sex between a man and a woman.
  12. You can become infected with HIV from kissing.
  13. A man can become infected with HIV if he has oral sex with a woman.
  14. A woman can become infected with HIV if she has oral sex with a man.
  15. Condoms can stop you becoming infected with HIV.

True/False Answer Sheet

  1. Sleeping around is not in itself risky, but having unprotected sex with an infected person is. By using condoms properly and consistently you can substantially reduce the risk of infection.
  2. Only if the needle or syringe has been contaminated with HIV. Injecting drug users should always use a clean needle and syringe.
  3. There are no known cases of HIV infection via toilet seats.
  4. It does not matter how healthy or unhealthy you are, if you engage in risky activities you stand a chance of being infected.
  5. This depends on the partners involved, what they did before they met, whether either has unprotected sex outside of the marriage or injects drugs using contaminated equipment. Marriage by itself offers no guarantees of safety.
  6. Reference Number 5
  7. Only condoms offer women protection against HIV, and even condoms cannot offer complete safety. Other forms of contraception do not offer protection from HIV.
  8. There is no evidence of transmission via this route, but it is sensible not to share toothbrushes for general health reasons.
  9. Most people with HIV will look perfectly healthy. Looks are therefore a useless way of assessing risk.
  10. Knowing someone well offers no reliable guide to whether or not they are infected with HIV.
  11. Anal sex is equally risky regardless of whether it takes place between two men or a man and a woman.
  12. There is no evidence of transmission in this way, although kissing when there are sores or cuts in the mouth may pose some risk.
  13. HIV is present in cervical and vaginal secretions as well as in (menstrual) blood, so there is the possibility of transmission this way.
  14. HIV is present in semen so there is a possibility of transmission in this way.
  15. Condoms used properly will help to prevent transmission of HIV from an infected partner to an uninfected partner. Condoms are not 100% safe though. Use a lubricant which is water based, as oil based lubricants can weaken the condom. When buying condoms check the ‘sell by’ date.

What is the Difference between HIV and AIDS

Ask the group if anyone knows what HIV stands for – Human immunodeficiency virus

Can anyone explain what HIV does inside the body? Let them present you with their opinions then explain:

HIV attacks the body’s immune system which is our body’s defense against infection and disease, and weakens it over time. A person who has HIV gradually loses the protection of his or her immune system and begins to experience health problems. These may be fairly small problems at first – skin problems or yeast infections – but over time the illnesses become more serious. The amount of time that it takes HIV to begin to affect a person’s health varies widely from one individual to another. When a person is diagnosed with one of the serious illnesses or cancers which are “AIDS-defining,” the person is then said to have AIDS.

More AIDS defining diseases can be found at: http://en.wikipedia.org/wiki/AIDS_defining_clinical_condition

HIV attacks the immune system mainly by damaging the CD4 (also known as T4 or T-helper) cells which help the body fight off diseases. HIV can also have direct effects upon the body. For example, the virus can attack cells in the brain and impair the brain’s function.

Ask the group if anyone knows what AIDS stands for – Acquired Immunodeficiency Syndrome

**Emphasis that on average: Every 2 hours, someone in Canada is infected with HIV.**

Ask youth what 5 fluids can contain enough of the virus to infect another person.

HIV can be transmitted from an infected person to another person through blood, semen (also known as “cum,”), vaginal fluids, anal secretions and breast milk.

Ask youth what type of high-risk behaviors the virus is spread through.

The main two causes of transmission are:

  • Unprotected oral, vaginal, or anal sexual intercourse
  • Sharing needles and works (including needles used for injecting steroids) and those used for tattooing

People who have another sexually transmitted disease, such as syphilis, genital herpes, chlamydia, gonorrhea, or bacterial vaginosis are at greater risk for getting HIV during sex with infected partners.

If a woman with HIV is pregnant, her newborn baby can catch the virus from her before birth, during the birthing process, or from breastfeeding. If doctors know an expectant mother has HIV, they can usually prevent the spread of the virus from mother to baby.

How Do People Know They Have HIV?

Once a person’s blood lacks the number of CD4 cells required to fight infections, or the person has signs of specific illnesses or diseases that occur in people with HIV infection, doctors make a diagnosis of AIDS.

Severe symptoms of HIV infection and AIDS may not appear for 10 years and for years leading up to that, a person may not have symptoms at all. The amount of time it takes for symptoms of AIDS to appear varies from person to person. Some people may feel and look healthy for years while they are infected with HIV. It is still possible to infect others with HIV, even if the person with the virus has absolutely no symptoms. You cannot tell simply by looking at someone whether he or she is infected.

When a person’s immune system is overwhelmed by AIDS, the symptoms can include:

  • extreme weakness or fatigue
  • rapid weight loss
  • frequent fevers that last for several weeks with no explanation
  • heavy sweating at night
  • swollen lymph glands
  • minor infections that cause skin rashes and mouth, genital, and anal sores
  • white spots in the mouth or throat
  • chronic diarrhea
  • a cough that won’t go away

Activity 2 Watch it Spread

Materials needed:

  • If there are 10 participants, you will need 10 small cups
  • Water, vinegar and baking soda
  • Marker

Activity Set Up:

  1. Mark the bottom of 1 cup with the letter S for STI.
  2. Mark the bottom of another cup with the letter I for injection drug user.
  3. Fill these 2 cups half full of vinegar
  4. Fill the rest of the cups half full of tap water

Explain to the group as a whole that this exercise will show them how easily infections can be passed on from person to person.

Hand out the cups at random and do not tell the participants that the cups are marked.

Ask the youth to walk around the room carrying their cup with them. When you say STOP, the youth will have to start a conversation about HEP C with the person closest to them.

Give approximately them 2 minutes to converse with each other.  At the end of 2 minutes the youth will pour all of their liquid into their conversation partner’s cup causing the liquids to mix, then pour half of it back into their own cup.

Have them do this twice, but emphasis that they need to have a different partner each time.

The first time they are told to stop, have them discuss different ways that HEP C can be contracted.

The second time they stop, have them discuss how the virus affects the body.

Bring the group back to a whole, go around the table and put a small amount of baking soda into each of their cups. The cups containing vinegar will foam. This means that they have contracted the virus. Allow them to look at the bottom of their cups to learn that only 2 of them started out with a virus and it has now spread to almost everyone in the room.

Likely Outcome

Youth will get a visual on how easily viruses can be passed on from person to person.

What is Hepatitis C?

Hepatitis C is a liver disease. Hepatitis means inflammation of the liver. Inflammation is the painful, red swelling that appears when tissues of the body become injured or infected.

How does liver damage occur in hepatitis C infection?

Over time (usually decades), prolonged inflammation may cause scarring. Extensive scarring in the liver is called cirrhosis. When the liver becomes cirrhotic, the liver fails to perform its normal functions, (liver failure), and this leads to serious complications and even death. Cirrhotic livers also are more prone to become cancerous.

What is the liver?

The liver is an organ that does many important things such as:

  • removes harmful chemicals from your blood
  • fights infection
  • helps digest food
  • stores nutrients and vitamins
  • stores energy

You cannot live without a liver.

HCV is spread (transmitted) most efficiently through inadvertent exposure to infected blood.

  • The most common route of transmission is needles or pipes shared among drug users
  • Accidental needle-sticks have also transmitted the virus.
  • All blood products are screened for HCV, and cases of HCV due to blood transfusion now are extremely rare.
  • HCV also can be passed from mother to unborn child. Approximately 4 of every 100 infants born to HCV-infected mothers become infected with the virus.
  • having sex with an infected person
  • being tattooed or pierced with unsterilized tools that were used on an infected person
  • using an infected person’s razor or toothbrush
  • Finally, there have been some outbreaks of HCV when instruments or sharp tool have been re-used without appropriate cleaning between patients. (spas, jails)
  • How to reduce your chances of contracting HIV or HEP C
  • Programs have been aimed at avoiding needle sharing among drug addicts. Needle exchange programs and educational interventions have reduced high-risk behaviors. However, the population of drug addicts is a difficult population to reach, and rates of HCV remain high among addicts (30% of younger users).
  • Among healthcare workers, safe needle-usage techniques have been developed to reduce accidental needle-sticks. Newer syringes have self-capping needle systems that avoid the need to manually replace a cap after drawing blood and reduce the risk of needle-sticks.
  • There is no clear way to prevent transmission of the HCV from mother to child.
  • Persons with multiple sexual partners should use barrier precautions such as condoms to limit the risk of HCV as well as other sexually-transmitted diseases.
  • Monogamous couples should consider the low risk of transmission when deciding whether to use condoms during intercourse. Some couples may decide to use them and some may not.
  • Screening tests for blood products have almost eliminated the risk of transmission through transfusion, estimated by the CDC to be less than one in two million transfused blood products.
  • People with HCV should not share razors or toothbrushes with others.
  • It is critical that physicians and clinics follow manufacturer’s directions for sterilizing/cleaning instruments and that disposable, sharp instruments be discarded properly.
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